INCIDENCE AND RISK FACTORS OF FOREARM HEMATOMA AFTER TRANSRADIAL PERCUTANEOUS CORONARY INTERVENTION

Abstract

Objective: To determine the incidence and risk factors of forearm hematoma after trans-radial percutaneous coronary intervention (TRA-PCI).

Methodology: In this observational study we included 450 consecutive patients who were referred to catheterization unit of Ch. Pervaiz Elahi Institute of cardiology between February 2019 and September 2019 were included. Patients planned for TRA were only included in analysis. We recorded demographic details, previous and presenting medical and clinical history, and renal parameters for each patient. Allen’s test was performed in each patient to determine the eligibility TRA. Incidence of forearm hematoma was noted immediately after the procedure.

Results: Out of 450 subjects enrolled in this study included, 324 (72%) were men and 126 (28.0%) were women, the mean age of the patients was 54±10 years. Forearm hematoma was diagnosed in only 51 (11.3%) patients. out of 51, 24 (47.0%) had grade I, 17 (33.3%) had grade II and 9 (17.6%) had grade III and 1 (1.96%) patients had grade IV hematoma. On univariate analysis, being women [odds ratio 2.2 (1.2-4.0), p-value=0.01], obesity [odds ratio 2.8 (1.54-5.76), p-value=0.001], and >1 puncture attempt [odds ratio 4.5 (2.36-8.51), p<0.001], were independent risk factors of forearm hematoma.

Conclusion: Incidence of hematoma after trans-radial percutaneous coronary intervention is 11.3%. Female gender, obesity and higher number of puncture attempts are independent risk factors of hematoma. Hematoma is mostly grade I-II in nature and can be managed easily only through conservative management.